Chemical structure: trichloroacetaldehyde monohydrate
Metabolites: 2,2,2-trichloroethanol, trichloracetic acid
Clinical use:
(1) sedative
(2) control of status epilepticus
Clinical effects:
(1) sedation
(2) skin irritation
(3) gastrointestinal irritation
(4) miosis
(5) agitation or rage reactions
(6) fruity (banana or pear) odor on breath
(7) at high doses can lead to ventricular arrhythmias that are often resistant to standard therapy.
(8) hypersensitivity reaction
(9) pulmonary edema
(10) hepatotoxicity
(11) respiratory depression
(12) hypotension
(13) disulfiram-like effect on exposure to alcohol
(14) seizures
(15) hallucinations or delusions
(16) CNS depression including coma
Toxic effects may occur at low doses in patients with severe liver disease since it is metabolized in the liver.
Cardiac arrhythmias may respond to:
(1) beta blockade and lidocaine
(2) flumazenil (a benzodiazepine antagonist)
(3) bretylium
Effects of chronic use:
(1) tolerance or dependence
(2) theoretically cancer (because of potential carcinogenic activity)
